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Biomedical subjects

A C Wilbur

Publications and source records attributed to A C Wilbur.

At least 19 recordsLinked to original sources
PubMed1998

Testicular microlithiasis: association with male infertility.

PURPOSE: We studied the frequency of testicular microlithiasis (TM) in a select group of otherwise healthy infertile men with abnormal semen. METHODS: We reviewed scrotal sonography records of 180 consecutive patients with abnormal semen who were referred for evaluation of male infertility. The pampiniform plexus was evaluated for possible varicocele, and the testes were examined for the presence or absence of intratesticular calcifications and/or masses. Five patients with more than 5 echogenic foci per transducer field in either testis were identified. The medical records and sonograms of this subgroup of patients were analyzed. RESULTS: Of the 180 patients, 5 (2.8%) had TM. Three patients with TM had concomitant small varicoceles; 2 others had a history of testicular maldescent. Two patients eventually became fertile. CONCLUSIONS: Our results indicate a higher than expected frequency of TM in otherwise healthy infertile men. We speculate that the magnitude of hypospermatogenesis in patients with TM is variable and may relate to both the degree of testicular dysgenesis and the presence or absence of concomitant scrotal pathology (eg, scrotal varicocele and cryptorchidism).

Adult↗
PubMed1997

The perinephric space and renal fascia: review of normal anatomy, pathology, and pathways of disease spread.

The perinephric space is a cone-shaped retroperitoneal compartment containing the kidney, adrenal gland, perinephric fat, fibrous bridging septa, and a rich network of perirenal vessel and lymphatics. Perinephric space pathology may originate from within or outside the confines of the perirenal fascia. Most intrinsic perinephric space disease arises from the kidney or adrenal gland, and secondarily involves the perinephric space. Disease originating outside the cone of renal fascia may spread to the perinephric space via lymphatics (i.e., metastatic spread) or by directly transgressing perirenal fascial planes (e.g., invasive tumor or infections). Additionally, infiltrating soft tissue or rapidly accumulating retroperitoneal fluid may travel into or out of the perinephric space via perinephric bridging septa and renal fascia. In this article, we review the normal anatomy of the perinephric space and renal fascia, emphasizing the significance of retroperitoneal interfascial planes and perinephric bridging septa as a potential conduit for retroperitoneal disease spread. This review of normal anatomy and pathways of disease spread serves as background for a discussion of a variety of specific pathologic conditions that may involve the perinephric space and retroperitoneal fascia, including pancreatitis, retroperitoneal hematoma, urinoma, metastatic disease, and perirenal varices.

Diagnostic Imaging↗
PubMed1995

Subcutaneous splenosis.

Splenosis is the ectopic implantation of splenic tissue, usually as the result of trauma. Intraperitoneal, intrathoracic, and retroperitoneal sites of implantation have been reported. The authors report a case of subcutaneous splenosis involving the abdominal wall that was imaged with CT and scintigraphy.

Abdominal Muscles↗
PubMed1993

Retrogastric colon: CT demonstration of anatomic variations.

In a series of 9,400 body computed tomographic (CT) scans of adult patients, a retrogastric course of the transverse colon with interposition of colon between the pancreatic body-tail and stomach was identified in 18 patients (0.2%). Three other patients (0.03%) had retrosplenic, retrogastric colon with transverse colon interposed between the spleen and posterior diaphragm. Three of the 18 patients with pancreaticogastric interposition also had small bowel malrotation. Clinically, no symptoms attributable to retrogastric colon were found. Retrogastric colons probably result from mild embryologic abnormalities of bowel rotation and fixation. Radiologically, colon in the area of the lesser sac must be differentiated from the normal duodenojejunal flexure, a perforated viscus, and abscess.

Adult↗
PubMed1993

Complications after laparoscopic cholecystectomy: imaging findings.

Laparoscopic cholecystectomy is rapidly becoming an acceptable alternative to traditional open cholecystectomy. Laparoscopic procedures are associated with shortened recovery periods and hospital stays and the cosmetic benefit of smaller scars. Early results from laparoscopic cholecystectomies suggested a high rate of complications; however, recent studies have shown that, in experienced hands, the complication rates of open and laparoscopic procedures are comparable. Complications differ somewhat between the two types of operations. In laparoscopic cholecystectomy, complications are associated with virtually every aspect of the procedure. The purpose of this essay is to illustrate the imaging findings of the complications that occur in patients undergoing laparoscopic cholecystectomy.

Abdominal Muscles↗
PubMed1992

Ureteric obstruction by the right testicular vein: CT diagnosis.

The close relationship of the ureter and gonadal blood vessels is often clearly demonstrated by computed tomography (CT). A case of ureteral obstruction in a man possibly caused by the crossing testicular vein is presented. Unlike the ovarian vein syndrome in women, which is often related to pregnancy and/or venous thrombosis, no predisposing factors were found.

Adult↗
PubMed1992

CT findings in tuboovarian abscess.

Pelvic inflammatory disease with tuboovarian abscess can cause a wide range of radiologic abnormalities. Although the diagnosis of tuboovarian abscess is usually straightforward and is based on clinical and sonographic findings, unusual or unsuspected cases may be confused with other pelvic or abdominal diseases. The purpose of this essay is to illustrate the CT findings in tuboovarian abscess.

Abscess↗
PubMed1991

CT and MRI of uterine lipoleiomyoma.

Uterine lipoleiomyomas are rare tumors containing variable amounts of fat. Diganostic considerations usually include ovarian fatty tumors and benign and malignant degeneration in ordinary leiomyomas. A case in which a preoperative diagnosis was made using computed tomography (CT) and magnetic resonance imaging (MRI) is presented. The fatty nature of the lesion was demonstrated with CT and standard spin echo MRI and further supported using inversion recovery MRI. MRI also clearly depicted the intrauterine location of the tumor.

Aged↗
PubMed1991

Basilar branch pontine infarction with prominent sensory signs.

We identified 10 patients with acute pontine infarction and specific sensory findings. Two patients had pure sensory symptoms, two had sensory complaints of the hand and mouth, and the other six had hemisensory loss referable to medial lemniscal or spinothalamic tract dysfunction but localized to one limb, to an arm and leg, or to the face, characteristic of stroke localized to the cerebral hemisphere. All patients had magnetic resonance imaging showing infarction of the medial or lateral pontine tegmentum and a patent basilar artery. No definite source for cardiogenic thromboembolism was found. Infarcts in the midline extending from the base of the pons posteriorly into the tegmentum suggested basilar branch occlusion, while infarcts involving only part of the tegmentum probably resulted from small penetrator branch occlusion. Vertigo, light-headedness, or cranial nerve dysfunction suggested a pontine location of neurological dysfunction in these patients, but the nature of the sensory findings did not always predict the lateral, medial, inferior, or superior extent of tegmental infarction.

Acute Disease↗
PubMed1990

Capsular hypesthetic ataxic hemiparesis.

Twenty-three patients with hypesthetic ataxic hemiparesis underwent computed tomography or magnetic resonance imaging. Twenty-two patients had infarcts of lacunar or slightly larger size in the contralateral posterior limb of the internal capsule. In 15 patients the infarct extended superiorly into the adjacent paraventricular region, and in seven it extended into the lateral thalmus. In eight patients the infarct was limited to the posterior limb of the internal capsule, and in only two patients was an ipsilateral to capsular pontine lacune found. Despite a location similar to that of pure motor and pure sensory lacunar stroke, hypesthetic ataxic hemiparesis correlates with larger infarcts, most often located in the posterior medial superior territory of the anterior choroidal artery. Some infarcts appeared to be localized immediately posterolateral to this region, in the posterior cerebral artery territory. The presence and extent of infarction is better detected by the addition of magnetic resonance imaging to computed tomography.

Adult↗
PubMed1989

Human leg neuromuscular diseases: P-31 MR spectroscopy.

Phosphorus-31 magnetic resonance (MR) spectra of leg muscles in patients with the neuromuscular diseases Duchenne dystrophy, myotonic dystrophy, postpoliomyelitis, Werdnig-Hoffmann disease, and pedal dystonia were recorded. Ratios of beta-adenosine triphosphate (ATP), inorganic phosphate (Pi), alpha-glycerophosphorylcholine (GPC), and phosphomonoesters to phosphocreatine (PCr) were calculated from peak integrals and compared with normal muscle ratios. In all diseases studied, beta-ATP/PCr and Pi/PCr values showed an increase from normal values. The extent of increase in beta-ATP/PCr was related to the clinical severity of the disease, suggesting that this could be a useful noninvasive means of monitoring effectiveness of therapy for neuromuscular disorders. In myotonic dystrophy and Werdnig-Hoffmann disease, GPC/PCr values increased greatly. The intracellular pH in Duchenne and postpoliomyelitis muscles was slightly elevated compared with that in normal muscles. Hydrogen-1 MR images of muscles showed fat infiltration in all patients, more in weaker muscles and less in stronger muscles.

Adenosine Triphosphate↗
PubMed1988

High-field MRI of primary gallbladder carcinoma.

The magnetic resonance (MR) imaging features are described in a case of gallbladder carcinoma presenting as a fungating mass associated with gallstones as well as biliary obstruction due to pancreaticoduodenal lymph node metastasis. The MR findings complemented diagnostic observations made on preoperative sonography and computed tomography of the abdomen.

Adenocarcinoma, Papillary↗
PubMed1988

In vivo H-1 spectroscopy in humans at 1.5 T.

Water-suppressed and section-selective proton (hydrogen-1) magnetic resonance (MR) spectra were recorded from human brain, leg muscle, liver, and heart with a 1.5-T imager. Signal from water was well suppressed, and resonances from several metabolites were consequently seen. The spectra from brains of healthy volunteers (n = 5) showed resonances from N-acetylaspartate, glutamine, aspartate, phosphocreatine/creatine, choline, taurine, and glycine. In five large brain meningiomas, resonances from N-acetyl-aspartate and phosphocreatine/creatine were either not visible or markedly decreased in intensity. The spectra from leg muscles of healthy volunteers showed resonances from protons in saturated fatty acyl chains, whereas resonances from unsaturated fatty acyl chains predominated in spectra from leg muscles of two patients with spina bifida. The spectra from livers of three healthy volunteers showed resonances from aliphatic and aromatic amino acids, choline, carnitine, and both saturated and unsaturated fatty acyl chains, and spectra from hearts of six healthy volunteers showed major resonances from phosphocreatine/creatine and taurine and smaller resonances from amino acids and fatty acyl chains.

Adipose Tissue↗